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[Perthes disease]

B Westhoff1, F Martiny1, R Krauspe1

  • 1Orthopädische Klinik, Universitätsklinikum Düsseldorf.

Zeitschrift Fur Orthopadie Und Unfallchirurgie
|December 23, 2014
PubMed

Insights

Perthes disease remains a challenge due to its unclear cause and debated treatments. Prognosis hinges on clinical and radiological factors, with range of motion and containment being key therapeutic targets.

Area of Science:

  • Orthopaedic surgery
  • Paediatric orthopaedics
  • Hip joint biomechanics

Context:

  • Perthes disease presents ongoing challenges in aetiology and treatment.
  • Prognosis is influenced by clinical factors like age and reduced range of motion, and radiological factors such as necrosis extent and containment.
  • Therapeutic interventions focus on addressing reduced range of motion and loss of containment.

Purpose:

  • To review the current understanding and management of Perthes disease.
  • To highlight the importance of clinical and radiological parameters in predicting prognosis.
  • To discuss the role of surgical interventions like pelvic osteotomies.

Summary:

  • Pelvic osteotomies offer significant corrective potential without the biomechanical drawbacks of other procedures.
  • Current treatment paradigms consider orthoses obsolete.
  • Management of non-containment focuses on symptomatic relief and correcting residual deformities.

Impact:

  • Effective management of Perthes disease can mitigate the risk of premature osteoarthritis and the need for early total hip replacement.
  • Understanding prognostic factors aids in tailoring treatment strategies.
  • Advancements in surgical techniques like pelvic osteotomies improve outcomes for patients with Perthes disease.

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